The Salt Talk: A Perspective on Public Health & Hypertension

Michael Alderman, M.D.

On Tuesday, December 11, 2012, Dr. Michael Alderman, distinguished professor emeritus of epidemiology & population health and of medicine, presented an intriguing research colloquium on dietary guidelines for salt and strategies for treating hypertension. In offering a departure from mainstream nutritional advice, Dr. Alderman provided those in attendance an ample serving of food for thought the next time someone says, "pass the salt."

His presentation took place in the Price Center/Block Pavilion's LeFrak Auditorium, sponsored by Einstein's Institute for Public Health Sciences.

Hypertension, or high blood pressure, affects nearly one-third of adults in the United States and represents the single most important preventable risk for premature death worldwide. The estimated cost of hypertension's effects among Americans is more than $70 billion per year, making it a major area of interest in academic and pharmaceutical research.

If left untreated, hypertension can lead to stroke, heart attack, and early death. Currently, individuals with hypertension are routinely advised to reduce their sodium intake. Perhaps not surprisingly, the National Dietary Guidelines for salt have been consistently lowered since the 1980s in the hopes of preventing this chronic condition.

In his presentation, Dr. Alderman, offered a somewhat different assessment based upon the most recently published evidence linking sodium intake to health outcomes. He noted that while decreasing salt intake can lower blood pressure, it also has several adverse health consequences. For example, reducing sodium consumption can increase insulin resistance, thereby increasing the risk of heart disease.

Furthermore, Dr. Alderman pointed out that there is convincing evidence now that, like most other essential nutrients, both too little and too much sodium intake can have ill effects. Therefore, he cautioned that the current strategy, advising all Americans to reduce sodium intake, needs to be revised, to insure that only those consuming too much sodium reduce their intake.

"Fortunately," he added, "most Americans currently consume sodium within the range compatible with optimal health and thus have no need to cut back."

Dr. Alderman, or "Mickey", as he was introduced, graduated from Yale Medical School in 1962. He has served in a variety of professional roles, including president of the American Society of Hypertension and president of the International Society of Hypertension. He is author of more than 270 scientific papers, book chapters and textbooks describing his research on hypertension in the community, its relation to cardiovascular disease, and the impact of therapy.